Expert Panel: Weighing The Value Of A Test For Psychopaths

>Many psychologists believe that psychopaths are almost bound by nature to commit crime. So if psychopaths can be accurately identified, their menace to society can be contained. That's the hope, at least.

But there is real debate about how to diagnose a psychopath and the usefulness of the tools available to do it. A test developed by psychologist Robert Hare called the Psychopathy Checklist-Revised, or PCL-R, is widely used in the criminal justice system — before trial, during sentencing and even in parole decisions — to evaluate a person's psychopathic tendencies.

Some psychologists believe the PCL-R is a critical tool in predicting which offenders pose the greatest risk. Others see the test as too vulnerable to human bias and question its place in the criminal justice system. We asked three experts in the field of forensic psychology to weigh in.

Masking Bias With Science

By Karen Franklin

Psychopathy is one of psychology's most resilient creations, impervious to myriad controversies over its checkered history and troubling legal implications.

Its roots lie in 19th century theories of innate criminality. Italian psychiatrist Cesare Lombroso, founder of criminal anthropology and a proponent of scientific racism, posited "a group of criminals, born for evil, against whom all social cures break as against a rock - a fact which compels us to eliminate them completely, even by death." This explanation of crime as rooted in biological degeneracy was embraced by the white supremacist eugenics movement of the early 20th century. The study of the "psychopathic personality" gained traction during the decades leading up to World War II and strongly influenced German scientists of the Third Reich.

By the late 20th century, movie renditions of the "bad seed," hard-wired by biology, had helped to cement the psychopath as a cultural icon. The current era of mass incarceration serves as a hothouse for its dark vision of humanity. By foregrounding intrinsic evil, psychopathy marginalizes social problems and excuses institutional failures at rehabilitation. We need not understand a criminal's troubled past or environmental influences. We need not reach out a hand to help him along a pathway to redemption. The psychopath is irredeemable, a dangerous outsider who must be contained or banished. Circular in its reasoning, psychopathy is nonetheless alluring in its simplicity.

Although modern psychopathy is more nuanced than its 19th century ancestor, diagnosing it remains an essentially subjective task. With its moralistic underpinnings, psychopathy functions as a coded language in correctional settings, for example. In a series of ethnographic studies, anthropologist Lorna Rhodes of the University of Washington found that prison clinicians use it and its watered-down cousin, antisocial personality disorder, to sort bodies into categories of "bad" (disliked) versus "mad" (pitied), thereby restricting access to limited treatment resources. Another researcher found that African-American prisoners are about twice as likely as equally eligible whites to be assigned this diagnosis.

Forensic psychology's current fixation with psychopathy is due in part to the modern notion that proper safety precautions can make life virtually risk-free. In response, courts and the public have tasked psychologists with predicting which individuals will engage in violent or otherwise depraved conduct in the future. Whether the much ballyhooed Psychopathy Checklist-Revised (PCL-R) can meaningfully assist in the quest for a crystal ball remains an open question.

In the meantime, with its invocation of monstrosity and danger, psychopathy exerts a powerfully prejudicial impact on judges and jurors. When assigned this pejorative label, juveniles are more likely to be transferred to adult court for harsher punishment, men who have committed sex offenses are more likely to be preventively detained as "sexually violent predators," and capital murder defendants are more likely to receive the death penalty.

Masking its implicit bias beneath a veneer of scientific objectivity, in adversarial settings psychopathy can literally be the kiss of death.

About Karen Franklin

Karen Franklin is a clinical and forensic psychologist in the San Francisco Bay Area and an adjunct professor at the California School of Professional Psychology. She gives frequent trainings on ethics in forensic practice and blogs about criminal justice issues at forensicpsychologist.blogspot.com.

Identifying The Bad Apples

By Henry Richards

The PCL-R is the most reliable tool the criminal justice system has to identify chronic, pathologic offenders. As such, it enables the corrections systems to make better decisions about resource allocation and interventions, and it increases the chance that treatment programs and alternatives to incarceration will be successful.

Psychopathic offenders start early, often in their preteen and teen years, and commit many crimes annually, often into late middle age and beyond. During their criminal careers, they chalk up more serious offenses than other criminals. Despite their destructive and repetitive conduct, many psychopaths are good at making excuses to trained professionals, eliciting sympathy and even admiration for their intrepid resolve to reform themselves.

PCL-R scores can help predict how an offender might behave in a variety of situations. They're useful to crime scene analysts who create profiles of perpetrators. Test scores can also help predict how someone might perform on conditional release (bail, probation, parole). And scores can guide choices about the type of institutional or community supervision that would work best for a particular offender and the likelihood that the offender will complete a rehabilitation program.

The test compares offenders with the successes and failures of other offenders. Among offenders with a previous violent offense, those with high PCL-R scores present the greatest risk for further violence. But the test can also can supply relevant information specific to an individual. For example, community supervision can start off on a firm footing with discussion of an offender's history of pathological lying, one of the items rated on the PCL-R.

Of course, all of our sources of information have costs, and none are infallible. The PCL-R is sometimes introduced, with prejudicial intention, in contexts where it has dubious relevance or moral justification — such as in death penalty considerations. But such misuses should not negate its benefits.

The success indicators for offenders on conditional release — such as rates of employment and recidivism, the presence of family support — offer the corrections system a reason for optimism, but only when you remove psychopaths from the analysis. Because psychopaths don't respond favorably to interventions or opportunities, they perform poorly on all these outcome measures relative to other offenders. And psychopaths typically have a spoiler effect on treatment programs — demoralizing others with their lies, hidden rule-breaking and readiness to exploit vulnerabilities.

Thanks to tools like the PCL-R, instead of wasting limited resources on a few bad apples, the justice system can focus those resources on the majority of offenders — those who can profit from a second chance and are, more often than not, motivated to change.

About Henry Richards

Henry Richards, Ph.D., a forensic psychologist in private practice, was formerly an executive overseeing statewide treatment programs for offenders in Maryland and Washington state. Richards is an associate clinical professor at the University of Washington School of Medicine and an associate professor of criminal justice at Seattle University.

An Unreliable And Stigmatizing Tool

By John Edens

The PCL-R is a 20-item rating scale used by mental health professionals to diagnose psychopathic criminal offenders. While the test may have value in certain circumstances within the criminal justice system, I have several reservations about its use as a risk assessment tool, such as when it is used to influence parole decisions or sentencing in death penalty cases.

Before reviewing these concerns, it is important to understand that a PCL-R score is composed of two somewhat distinct parts, which I'll refer to as the personality and criminal history components. Several of the 20 items require the examiner to rate personality traits that we historically think of when we use the term "psychopath," such as whether the person shows a lack of remorse or guilt, appears callous, seems superficially charming, and has an inflated sense of self-worth (i.e., the personality component).

Many of the remaining PCL-R items, however, are scored simply by rating the extensiveness of someone's history of criminal and antisocial conduct, such as how many different types of crimes were committed (i.e., the criminal history component). Although the two components are related, it's important to note that there are lots of people with extensive criminal histories who don't have a psychopathic personality.

My primary reservation about using the PCL-R in the criminal justice system is that research suggests its personality component and the label "psychopath" are highly stigmatizing, evoking images of fictional villains like Hannibal Lecter as well as real-world serial killers such as Ted Bundy and Jeffrey Dahmer. Calling someone a remorseless, callous psychopath can have a profound impact on how that person is viewed by others, such as members of a jury or a parole board.

Before using such a potentially stigmatizing rating scale, one should have a lot of confidence that (a) experts can actually agree on who truly is a psychopath, and (b) the personality component of the PCL-R actually is important to consider in determining how dangerous the person is.

But recent research suggests that the scores examiners give to defendants in real-world cases seem to be considerably less consistent and objective than we've historically thought. Everyone might easily agree, for example, that someone like Hannibal Lecter is a psychopath, but it gets considerably fuzzier when you start talking about an actual person.

And, very important, experts disagree the most on the personality component of the PCL-R, perhaps because scoring it involves much more subjective judgment than does the criminal history component. Moreover, existing research suggests it is the criminal history component of the PCL-R — not the (less reliable) personality component — that is most helpful in identifying those likeliest to commit future crimes.

There are a number of other risk assessment tools available to experts that assess criminal history independent of personality. If other risk assessment methods work as well or better than the PCL-R and are not tied to the "psychopath" label, why rely on a rating scale that includes largely irrelevant and possibly unreliable items concerning how remorseless and callous someone is judged to be?

About John Edens

John Edens, Ph.D., is a licensed psychologist and professor of psychology at Texas A&M University. He has published an array of research articles on psychopathy and forensic psychology and is identified in Thompson Scientific's "Essential Science Indicators" as in the top 1 percent of cited researchers in the psychology/psychiatry field over the past 10 years. He currently serves on the editorial board of numerous scientific journals (e.g., Psychological Assessment, Law & Human Behavior) and is a former associate editor of the scientific journal Assessment.